| NPI | 1538200209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA MUSIC Director Provider Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| 207T00000X Neurological Surgery | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology | |
| 208000000X Pediatrics | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2025-07-09 |